Organization
JACY 1
Active
Organization
JACY 1
Active
Other names
Anchorage
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEE LITKE (EXECUTIVE ASSISTANT)
(320) 255-9530
Entity
Organization
Contact information
Practice address
600 25TH AVE S STE 105, SAINT CLOUD, MN 56301-4820
(320) 255-9530
Mailing address
600 25TH AVE S STE 105, SAINT CLOUD, MN 56301-4820
(320) 255-9530
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
10447991CDT
MN
Other
Enumeration date
04/30/2008
Last updated
04/30/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up